A nurse is planning care for a client who has neurogenic shock following a spinal cord injury. Which of the following provider prescriptions should the nurse anticipate? (Select all that apply.)
(Select All that Apply.)
Metoprolol
Lactated Ringers intravenous fluid
Furosemide
Dopamine
Epinephrine
Correct Answer : B,D,E
Choice A Reason:
Metoprolol is incorrect. Metoprolol is a beta-blocker medication commonly used to treat conditions such as hypertension, angina, and heart failure. However, in the context of neurogenic shock following a spinal cord injury, the use of beta-blockers such as metoprolol is generally contraindicated. Beta-blockers antagonize the effects of sympathetic activation, leading to a reduction in heart rate and myocardial contractility, which can exacerbate hypotension and bradycardia, the hallmarks of neurogenic shock. Therefore, the nurse would not anticipate a prescription for metoprolol in the management of neurogenic shock.
Choice B Reason:
Lactated Ringers intravenous fluid is correct. Fluid resuscitation with isotonic crystalloid solutions such as lactated Ringers is essential to restore intravascular volume and improve perfusion.
Choice C Reason:
Furosemide is incorrect. Furosemide is a loop diuretic medication commonly used to treat conditions such as heart failure, edema, and hypertension by promoting diuresis and reducing fluid volume. However, in the context of neurogenic shock, the use of diuretics such as furosemide is generally not indicated unless there is concurrent volume overload. Neurogenic shock is characterized by hypotension due to vasodilation and decreased systemic vascular resistance, often leading to relative hypovolemia rather than volume overload. Therefore, administering furosemide could further decrease intravascular volume, exacerbating hypotension and compromising perfusion. As a result, the nurse would not anticipate a prescription for furosemide in the management of neurogenic shock.:
Choice D Reason:
Dopamine is correct. Dopamine is a vasopressor medication that acts to increase vascular tone and blood pressure by stimulating alpha-adrenergic receptors. It is commonly used in the management of neurogenic shock to augment blood pressure.
Choice E Reason:
Epinephrine is correct. Epinephrine is a potent vasopressor that acts on both alpha and beta-adrenergic receptors, leading to vasoconstriction and increased cardiac output. It is used in the treatment of refractory hypotension in neurogenic shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
Choice A Reason:
Loss of teeth is not typically considered a direct factor contributing to obstructive sleep apnea. While the presence of teeth may play a role in maintaining the structure of the oral cavity, it is not a primary risk factor for OSA.
Choice B Reason:
Stroke is correct. Individuals who have had a stroke are at increased risk of developing obstructive sleep apnea. Stroke can cause damage to areas of the brain involved in controlling breathing and upper airway function, leading to disruptions in respiratory control during sleep.
Choice C Reason:
Sleepiness is a symptom commonly associated with obstructive sleep apnea rather than a direct contributing factor. Excessive daytime sleepiness is a consequence of disrupted sleep patterns and recurrent episodes of breathing cessation during the night, which are characteristic features of obstructive sleep apnea.
Choice D Reason:
Fatty deposits is correct. Excessive fatty deposits, particularly around the neck and throat, can contribute to the narrowing and collapse of the upper airway during sleep, increasing the risk of obstructive sleep apnea. Obesity is a significant risk factor for OSA due to the accumulation of fat deposits in the upper airway tissues.
Choice E Reason:
Muscle dysfunction is correct. Muscle dysfunction, particularly of the muscles surrounding the upper airway, can impair the ability of these muscles to keep the airway open during sleep. Weakness or dysfunction of these muscles can lead to increased collapsibility of the upper airway, contributing to obstructive sleep apnea.
Correct Answer is D
Explanation
Choice A Reason:
Depression is incorrect. While depression can contribute to headaches in some individuals, it is more commonly associated with migraine headaches rather than tension-type headaches or cluster headaches. People with depression may experience changes in neurotransmitter levels and alterations in pain perception, which can exacerbate migraines. However, tension-type headaches and cluster headaches are generally less strongly associated with depression as a precipitating factor compared to migraines.
Choice B Reason:
Smoking is incorrect. Smoking can be a trigger for headaches in some individuals, particularly migraines, due to the vasoconstrictive effects of nicotine and other compounds in tobacco smoke. However, smoking is not universally recognized as a common precipitating factor for tension-type headaches or cluster headaches. While individuals with cluster headaches may have higher rates of smoking compared to the general population, it is not a factor commonly shared with tension-type headaches.
Choice C Reason:
Poor posture is incorrect. Poor posture can contribute to muscle tension and cervical spine strain, which may trigger tension-type headaches. However, poor posture is not typically considered a precipitating factor specific to cluster headaches. While tension-type headaches may be exacerbated by poor posture, cluster headaches are characterized by severe, unilateral pain typically centered around the eye or temple, with associated autonomic symptoms such as tearing, nasal congestion, or ptosis.
Choice D Reason:
Stress is correct. Stress is a well-established precipitating factor for both tension-type headaches and cluster headaches. Stress can lead to muscle tension and contraction, which are common triggers for tension-type headaches. Additionally, stress can also contribute to the onset or worsening of cluster headaches, although the exact mechanisms underlying this association are not fully understood. Therefore, stress is a common precipitating factor for both tension-type headaches and cluster headaches.
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